Abstract
Background
Osteoporosis is the most common metabolic bone disease; vertebral fractures are the most common osteoporotic fractures.
Methods
Several radiological scoring methods using different criteria for osteoporotic vertebral fractures exist. Quantitative morphometry (QM) uses ratios derived from direct vertebral body height measurements to define fractures. Semi-quantitative (SQ) visual grading is performed according to height and area reduction. The algorithm-based qualitative (ABQ) method introduced a scheme to systematically rule out non-fracture deformities and diagnoses osteoporotic vertebral fractures based on endplate depression. The concordance across methods is currently a matter of debate.
Results
This article reviews the most commonly applied standardised radiographic scoring methods for osteoporotic vertebral fractures, attaining an impartial perspective of benefits and limitations. It provides image examples and discusses aspects that facilitate large-scale application, such as automated image analysis software and different imaging investigations. It also reviews the implications of different fracture definitions for scientific research and clinical practice.
Conclusion
Accurate standardised scoring methods for assessing osteoporotic vertebral fractures are crucial, considering that differences in definition will have implications for patient care and scientific research. Evaluation of the feasibility and concordance among methods will allow establishing their benefits and limitations, and most importantly, optimise their effectiveness for widespread application.
Key Points
• Several scoring methods using different criteria for assessing osteoporotic vertebral fractures exist.
• Standardised osteoporotic vertebral fracture assessment should be applicable to different radiological investigations.
• Accurate assessment of osteoporotic vertebral fractures is essential for proper patient management.
• Optimising feasibility of scoring methods enables widespread use in scientific research.
• Assessment of concordance between methods is important for application in patient care.
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Abbreviations
- BMD:
-
Bone mineral density
- QM:
-
Quantitative morphometry
- SQ:
-
Semi-quantitative method
- SFI:
-
Spinal fracture index
- ABQ:
-
Algorithm-based qualitative method
- DXA:
-
Dual-emission X-ray absorptiometry
- SD:
-
Standard deviation
- FRAX:
-
Fracture risk assessment tool
- VFA:
-
Vertebral fracture assessment
- CT:
-
Computed tomography
- MRI:
-
Magnetic resonance imaging
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Acknowledgements
Part of the content of this article was presented as a scientific poster presentation at the American Society for Bone and Mineral Research Annual Meeting in San Diego, CA, USA, from 16–20 September 2011 and as an educational exhibit at the RSNA Annual Meeting in Chicago, IL, USA, from 27 November-2 December 2011.
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Oei, L., Rivadeneira, F., Ly, F. et al. Review of radiological scoring methods of osteoporotic vertebral fractures for clinical and research settings. Eur Radiol 23, 476–486 (2013). https://doi.org/10.1007/s00330-012-2622-z
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DOI: https://doi.org/10.1007/s00330-012-2622-z